L1681
Prosthetics & Orthotics
53 States
Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
Short Desc
Ho bilateral hip abduction
Coverage determined by local carrier discretion.
Added Date
2023-10-01
Effective From
2023-10-01
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$3,237.30
|
Same |
|
AL
|
Base Rate |
$2,289.00
|
Same |
|
AR
|
Base Rate |
$2,096.44
|
Same |
|
AZ
|
Base Rate |
$2,795.26
|
Same |
|
CA
|
Base Rate |
$2,795.26
|
Same |
|
CO
|
Base Rate |
$2,362.90
|
Same |
|
CT
|
Base Rate |
$2,311.32
|
Same |
|
DC
|
Base Rate |
$2,638.78
|
Same |
|
DE
|
Base Rate |
$2,638.78
|
Same |
|
FL
|
Base Rate |
$2,289.00
|
Same |
|
GA
|
Base Rate |
$2,289.00
|
Same |
|
HI
|
Base Rate |
$3,461.66
|
Same |
|
IA
|
Base Rate |
$2,096.44
|
Same |
|
ID
|
Base Rate |
$2,125.86
|
Same |
|
IL
|
Base Rate |
$2,303.12
|
Same |
|
IN
|
Base Rate |
$2,303.12
|
Same |
|
KS
|
Base Rate |
$2,096.44
|
Same |
|
KY
|
Base Rate |
$2,289.00
|
Same |
|
LA
|
Base Rate |
$2,096.44
|
Same |
|
MA
|
Base Rate |
$2,311.32
|
Same |
|
MD
|
Base Rate |
$2,638.78
|
Same |
|
ME
|
Base Rate |
$2,311.32
|
Same |
|
MI
|
Base Rate |
$2,303.12
|
Same |
|
MN
|
Base Rate |
$2,303.12
|
Same |
|
MO
|
Base Rate |
$2,096.44
|
Same |
|
MS
|
Base Rate |
$2,289.00
|
Same |
|
MT
|
Base Rate |
$2,362.90
|
Same |
|
NC
|
Base Rate |
$2,289.00
|
Same |
|
ND
|
Base Rate |
$2,362.90
|
Same |
|
NE
|
Base Rate |
$2,096.44
|
Same |
|
NH
|
Base Rate |
$2,311.32
|
Same |
|
NJ
|
Base Rate |
$2,795.26
|
Same |
|
NM
|
Base Rate |
$2,096.44
|
Same |
|
NV
|
Base Rate |
$2,795.26
|
Same |
|
NY
|
Base Rate |
$2,795.26
|
Same |
|
OH
|
Base Rate |
$2,303.12
|
Same |
|
OK
|
Base Rate |
$2,096.44
|
Same |
|
OR
|
Base Rate |
$2,125.86
|
Same |
|
PA
|
Base Rate |
$2,638.78
|
Same |
|
PR
|
Base Rate |
$3,045.74
|
Same |
|
RI
|
Base Rate |
$2,311.32
|
Same |
|
SC
|
Base Rate |
$2,289.00
|
Same |
|
SD
|
Base Rate |
$2,362.90
|
Same |
|
TN
|
Base Rate |
$2,289.00
|
Same |
|
TX
|
Base Rate |
$2,096.44
|
Same |
|
UT
|
Base Rate |
$2,362.90
|
Same |
|
VA
|
Base Rate |
$2,638.78
|
Same |
|
VI
|
Base Rate |
$2,795.26
|
Same |
|
VT
|
Base Rate |
$2,311.32
|
Same |
|
WA
|
Base Rate |
$2,125.86
|
Same |
|
WI
|
Base Rate |
$2,303.12
|
Same |
|
WV
|
Base Rate |
$2,638.78
|
Same |
|
WY
|
Base Rate |
$2,362.90
|
Same |